This is a competing renewal of Dr. Michael V. Vitiello's NIMH Independent Scientist Award, K02-MH01158, Age-Related Sleep Disturbance Possible Interventions. As much as 40% of the older population complains of significant, chronic sleep disturbance. Sleep complaints often lead to chronic sedative hypnotic use and the elderly receive a disproportionate number of such prescriptions. Sedative-hypnotics offer short-term relief but their long-term efficacy is unclear and chronic use has been associated with increased morbidity and mortality. A recent NIH Consensus Conference concluded that chronic hypnotic use is inappropriate and that non-sedative interventions for sleep disruption are sorely needed. Dr. Vitiello proposes three specific aims that will examine possible non-sedative hypnotic approaches to improving the sleep quality of the elderly: Specific Aim 1: Examine the usefulness of fitness training interventions to improve the sleep quality of older men and women. Specific Aim 2: Examine the usefulness of neuroendocrine interventions (e.g., growth hormone releasing hormone, estrogen, and testosterone supplementation) to improve the sleep quality of older men and women. Specific Aim 3: Examine the usefulness of cognitive behavioral techniques to improve the sleep quality of older men and women in a number of different settings. While pursuing these aims, Dr. Vitiello will develop additional expertise in the interactions of sex steroids and sleep quality, ambulatory monitoring of sleep and respiration, actigraphic recording of rest/activity rhythms and cognitive behavioral interventions for sleep disturbance in the elderly. Each of these proposed lines of research has considerable significance for our understanding of the causes of,and potential treatments for, sleep disturbance in the aged. Effective non- sedative interventions may significantly improve not only sleep quality but also overall the quality of life in the elderly. Further, such interventions may have significant impact in decreasing morbidity and mortality directly related to such sleep disturbance or its inappropriate treatment with chronic hypnotic medications.